Abstract
Resections of primary pelvic bone tumors are frequently complicated by surgical site infections (SSIs), thereby impairing the functional prognosis of patients, especially in case of implant removal. Although prophylactic antibiotics play an essential role in preventing SSIs, there are presently no recommendations that support their appropriate use. This study aimed to assess the impact of a 24 h prophylactic protocol on the bacterial ecology, the resistance pattern, and the SSI healing rate. We hypothesized that this protocol not only limits the emergence of resistance but also results in a good cure rate with implant retention in case of SSI. A retrospective study was performed that included all patients with an SSI following a pelvic bone tumoral resection between 2005 and 2017 who received a 24 h antibiotic prophylaxis protocol. Twenty-nine patients with an SSI were included. We observed a 75.9% rate of polymicrobial infection, with a high prevalence of digestive flora microorganisms and a majority of wild-type phenotypes. We confirmed that there was no significant emergence of resistant flora. After first-line debridement, antibiotics (DA) if any implant was used, or debridement, antibiotics, and implant retention (DAIR) whenever possible, we obtained a 79.3% cure rate, with implant removal in 20% of cases. The absence of an implant was significantly associated with SSI healing. Early infection management and low resistance profiles may also have a positive effect, but this needs to be confirmed in a larger cohort. In light of this, the use of a 24 h prophylactic protocol in primary pelvic bone tumor resections is associated with a favorable infection cure rate and implant retention in case of SSI, and minimal selection of resistant microorganisms.
Highlights
A Short-Course Antibiotic Prophylaxis Is Associated withYoann Varenne 1 , Stéphane Corvec 2,3,†,‡ , Anne-Gaëlle Leroy 2,4,† , David Boutoille 5,† , Mỹ-Vân Nguyễn 1 , Sophie Touchais 1,† , Pascale Bémer 2,† , Antoine Hamel 6,7 , Denis Waast 1 , Christophe Nich 1,8 , François Gouin 1,9,§ and Vincent Crenn 1,8, *,†,§
Primary tumors of the pelvis are rare, accounting for no more than 15% of all primary bone tumors [1]
We believe that a 24 h short antibiotic prophylaxis [17] may increase the rate of surgical site infections (SSIs) healing, which may be due to early infection
Summary
Yoann Varenne 1 , Stéphane Corvec 2,3,†,‡ , Anne-Gaëlle Leroy 2,4,† , David Boutoille 5,† , Mỹ-Vân Nguyễn 1 , Sophie Touchais 1,† , Pascale Bémer 2,† , Antoine Hamel 6,7 , Denis Waast 1 , Christophe Nich 1,8 , François Gouin 1,9,§ and Vincent Crenn 1,8, *,†,§. CRCINA, INSERM, University of Angers, University of Nantes, 44000 Nantes, France. Laboratoire EA 3826 “Thérapeutiques Cliniques et Expérimentales des Infections”, IRS2-Nantes Biotech, University of Nantes, 44000 Nantes, France. Département de Chirurgie, Centre de Lutte Contre le Cancer Léon Bérard, 69008 Lyon, France. ESGIAI (ESCMID Study Group for Implant-Associated Infections) Member. Last two authors contributed to this work. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
